Board Approved June 9, 2014

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1 Board Approved June 9, 2014 Our casualty insurance package policy includes coverage for General Liability, Educators Legal, Employment Practices, Automobile Liability, Auto Physical Damage and Workers Compensation Coverage. In addition, we purchase coverage for our employed medical professionals (Healthcare E&O), our students participating in the Certified Nursing Assistant Program (Student Professional E&O) and Catastrophic Student Accident coverage as required by FHSAA. Arthur J. Gallagher is the District s broker for these insurance programs. On October 1, 2013 the District transitioned from a fully insured casualty insurance program to a self- insurance program consisting of All Lines Aggregate coverage through BRIT with additional excess workers compensation coverage through Safety National. The program includes stop loss protection coverage to avoid accumulation of losses within a policy year of $3,500,000. There is a SIR (self insured retention) of $100,000 per claim for Automobile, General and Professional Liability and a $250,000 per claim SIR for Workers Compensation. Claims management services are provided by CCMSI, a Third Party Administrator. The Healthcare E&O and Student Professional E&O are fully insured and carry no deductible. The Catastrophic Student Accident Insurance carries a $25,000 per claim deductible. Primarily due to improved workers compensation claims experience, our broker was able to negotiate a 7.01% reduction in premiums over the expiring policies. Expiring annualized premiums - $1,340, Renewal premiums - $1,245, Savings over last year - $95, G4-1

2 Arthur J. Gallagher Risk Management Services Premium Summary The estimated program cost for the recommended program/options are outlined in the following table: Package I Premium Certain Underwriters at $561, I Certain Underwriters at I $561, Taxes Lloyd's (Brit Syndicate - Lloyd's (Brit Syndicate Srchrg & Asmnt %) $7, %) I $7, Estimated Cost $568, 799.5o 1 I $568, Included Included Healthcare E&O - Professional Premium Arch Specialty Insurance $14, Arch Specialty Insurance $15, Liability I Taxes Company (Arch Insurance - Company (Arch Insurance Srchrg & Asmnt Group) - Group) Estimated Cost $14,859.oo 1 I $15, E&O -Student Professional Premium American Casualty $1, American Casualty I $1, Liability I Taxes Company of Reading, - Company of Reading, Srchrg & Asmnt Pennsylvania (CNA $11.34 Pennsylvania (CNA Insurance Companies) $10.00 Insurance Companies) $10.00 Estimated Cost $1, I $1, Catastrophic Student Accident I Premium Zurich American Insurance $16, Zurich American Insurance $12, Taxes Company of Illinois (Zurich - Company (Zurich Financial Srchrg & Asmnt Financial Services Ltd) - Services Ltd) - Estimated Cost $16, I $12, G4-2 Proposal for Lake County School Board 8

3 ";> Arthur J. Gallagher Risk Management Services Excess Workers Compensation Premium I Safety National Casualty Taxes Corporation (Safety Srchrg & Asmnt National Group) Estimated Cost $539, I Safety National Casualty - Corporation (Safety - National Group) $539, Included $447, $447, Included Broker Services Fee $200, $200, Total Estimated Program Cost $1,340, $1,245, ($95,003.34) (7.01%) Quote from Certain Underwriters at Lloyd's (Brit Syndicate %) is valid untiis/11/2014 Quote from Arch Specialty Insurance Company is valid until7/1/2014 Quote from American Casualty Company of Reading, Pennsylvania is valid until 8/1/2014 Quote from Zurich American Insurance Company is valid until 8/1/2014 Quote from Safety National Casualty Corporation is valid until7/1/2014 Gallagher is responsible for the placement of the following lines of coverage: Package E&O- Student Professional Liability Healthcare E&O - Professional Liability Catastrophic Student Accident Excess Workers Compensation It is understood that any other type of exposure/coverage is either self-insured or placed by another brokerage firm other than Gallagher. If you need help in placing other lines of coverage or covering other types of exposures, please contact your Gallagher representative. Pro-Rata/Undecided State Surplus Lines Disclaimer If you elect to bind coverage with a non-admitted carrier. Surplus lines taxes must be collected and remitted to your Home State, as defined in The Non-admitted and Reinsurance Reform Act. Your Home State has not yet established a process for the remittance of the non-home State portion of the tax. We intend to bill the surplus lines taxes for the non Home States, and hold these taxes until a process for remittance is established and payment to the non-home State may be made. If no such process is established by the Home State, and the risk of future claim by the non-home State is determined to no longer exist, then the taxes will be returned to you. G4-3 Proposal for Lake County School Board 9

4 Arthur]. Gallagher Risk Management Services Client Authorization to Bind Coverage After careful consideration of Gallagher's proposal dated 5/22/2014, we accept the following coverage(s). Please check the desired coverage(s) and note any coverage amendments below: [J Accept [J Reject I E&O - Student Professional Liability American Casualty Company of Reading, Pennsylvania (CNA Insurance Companies) [J Accept [J Reject I Catastrophic Student Accident Zurich American Insurance Company (Zurich Financial Services Ltd) [J Accept [J Reject I Excess Workers Compensation Safety National Casualty Corporation (Safety National Group) TRIA cannot be rejected I TRIA Coverage [J Accept [J Reject I Package - All Lines Aggregate Underwriters at Lloyd's (Brit %) [J Accept [J Reject I TRIA Coverage Producer/Insured Coverage Amendments and Notes: Client Initials G4-4 Prooosa/ for Lake Countv School Board 40

5 Arthur). Gallagher Risk Management Services educing Rlttk. Ratslna qiit:!!ectatlons Client Authorization to Bind Coverage Provide Quotations or Additional Information on the Following Coverage Considerations: Umbrella 0 Yes 0 No Increased Limits Other Coverage Considerations 0 Yes 0 No Cyber Risk 0 Yes 0 No Environmental Pollution Liability 0 Yes 0 No Fiduciary liability 0 Yes 0 No Foreign Exposures 0 Yes 0 No Terrorism 0 Yes 0 No Violent Malicious Acts 0 Yes 0 No Excess Auto Physical Damage Note: Selecting the "Reject All or Accept All" option will override any selections that you have made above 0 Reject All [J Accept All - Coverages for Consideration It is understood this proposal provides only a summary of the details; the policies will contain the actual coverages. We confirm the values, schedules, and other data contained in the proposal are from our records and acknowledge it is our responsibility to see that they are maintained accurately. We agree that your liability to us arising from your negligent acts or omissions, whether related to the insurance or surety placed pursuant to these binding instructions or not, shall not exceed $20 million, in the aggregate. Further, without limiting the foregoing, we agree that in the event you breach your obligations, you shall only be liable for actual damages we incur and that you shall not be liable for any indirect, consequential or punitive damages. By: Specify: owner, partner or corporate officer Print Name Date: G4-5